Clinicopathologic Features of Adult-onset Still's Disease Complicated by Severe Liver Injury
Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder. Severe liver injury has rarely been reported, although liver enzyme elevation is a common complication of AOSD. We herein report four cases of relapsed AOSD with severe liver disorder by tapering or terminating corticostero...
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| Veröffentlicht in: | Internal Medicine 2024/02/15, Vol.63(4), pp.503-511 |
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| creator | Kurokawa, Miho Hioki, Tomonobu Aoyagi, Tomomi Takahashi, Motoi Imoto, Koji Goya, Takeshi Tanaka, Masatake Kohjima, Motoyuki Ogawa, Yoshihiro |
| description | Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder. Severe liver injury has rarely been reported, although liver enzyme elevation is a common complication of AOSD. We herein report four cases of relapsed AOSD with severe liver disorder by tapering or terminating corticosteroids. Liver specimens revealed robust infiltration of inflammatory cells throughout the lobule, especially cluster of differentiation (CD) 8-positive cells. Relapsed AOSD was refractory to corticosteroid reintroduction and required immunosuppressants. Severe liver injury with AOSD is pathologically characterized by extensive lobular infiltration of CD8-positive cells, and we should consider additive immunosuppressive agents on corticosteroids for treatment. |
| doi_str_mv | 10.2169/internalmedicine.2043-23 |
| format | Article |
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Severe liver injury has rarely been reported, although liver enzyme elevation is a common complication of AOSD. We herein report four cases of relapsed AOSD with severe liver disorder by tapering or terminating corticosteroids. Liver specimens revealed robust infiltration of inflammatory cells throughout the lobule, especially cluster of differentiation (CD) 8-positive cells. Relapsed AOSD was refractory to corticosteroid reintroduction and required immunosuppressants. Severe liver injury with AOSD is pathologically characterized by extensive lobular infiltration of CD8-positive cells, and we should consider additive immunosuppressive agents on corticosteroids for treatment.</description><identifier>ISSN: 0918-2918</identifier><identifier>EISSN: 1349-7235</identifier><identifier>DOI: 10.2169/internalmedicine.2043-23</identifier><identifier>PMID: 37344425</identifier><language>eng</language><publisher>Japan: The Japanese Society of Internal Medicine</publisher><subject>acute liver injury ; Adrenal Cortex Hormones - therapeutic use ; Adult ; adult-onset Still's disease ; Case Report ; CD8 antigen ; CD8-positive cells ; Cell differentiation ; Corticosteroids ; Humans ; Immunosuppressive agents ; Immunosuppressive Agents - therapeutic use ; Infiltration ; Inflammatory diseases ; Juvenile rheumatoid arthritis ; Liver ; Liver diseases ; Still's Disease, Adult-Onset - complications ; Still's Disease, Adult-Onset - drug therapy</subject><ispartof>Internal Medicine, 2024/02/15, Vol.63(4), pp.503-511</ispartof><rights>2024 by The Japanese Society of Internal Medicine</rights><rights>2024. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). 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Med.</addtitle><description>Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder. Severe liver injury has rarely been reported, although liver enzyme elevation is a common complication of AOSD. We herein report four cases of relapsed AOSD with severe liver disorder by tapering or terminating corticosteroids. Liver specimens revealed robust infiltration of inflammatory cells throughout the lobule, especially cluster of differentiation (CD) 8-positive cells. Relapsed AOSD was refractory to corticosteroid reintroduction and required immunosuppressants. Severe liver injury with AOSD is pathologically characterized by extensive lobular infiltration of CD8-positive cells, and we should consider additive immunosuppressive agents on corticosteroids for treatment.</description><subject>acute liver injury</subject><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>Adult</subject><subject>adult-onset Still's disease</subject><subject>Case Report</subject><subject>CD8 antigen</subject><subject>CD8-positive cells</subject><subject>Cell differentiation</subject><subject>Corticosteroids</subject><subject>Humans</subject><subject>Immunosuppressive agents</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Infiltration</subject><subject>Inflammatory diseases</subject><subject>Juvenile rheumatoid arthritis</subject><subject>Liver</subject><subject>Liver diseases</subject><subject>Still's Disease, Adult-Onset - complications</subject><subject>Still's Disease, Adult-Onset - drug therapy</subject><issn>0918-2918</issn><issn>1349-7235</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkU9vEzEQxVcIRNPCV0CWOMBli_-s1_YJVYGWShEcCjcky-vMJo4cO9jeSvn2OEqIoFxmDvObN_Z7TYMIvqakVx9cKJCC8VtYOusCXFPcsZayZ82MsE61gjL-vJlhRWRLa7loLnPeYMykUPRlc8EE67qO8lnzc-5dcDbuTFlHH1fOolswZUqQURzRzXLypY0hQ0EPxXn_LqNPLoPJgOZxu_POmgJLNOzRAzxCArRwtaH7sJnS_lXzYjQ-w-tTv2p-3H7-Pv_SLr7d3c9vFq3lUpaW4pFjhfEAYIiQAwUhmCFmGFkHgltqe6MAOiVHYpa4xx3m_YC5HUdOlhbYVfPxqLubhmqJhVCS8XqX3NakvY7G6X8nwa31Kj5qghUThMmq8P6kkOKvCXLRW5cteG8CxClrKqkUnFbLKvr2CbqJ0yGMSikuqskK95WSR8qmmHOC8fwagvUhQ_00Q33IUFNWV9_8_Zvz4p_QKvD1CGxyMSs4AyYVZz38r9wz3R3K6cIZtGuTNAT2G1zju_U</recordid><startdate>20240215</startdate><enddate>20240215</enddate><creator>Kurokawa, Miho</creator><creator>Hioki, Tomonobu</creator><creator>Aoyagi, Tomomi</creator><creator>Takahashi, Motoi</creator><creator>Imoto, Koji</creator><creator>Goya, Takeshi</creator><creator>Tanaka, Masatake</creator><creator>Kohjima, Motoyuki</creator><creator>Ogawa, Yoshihiro</creator><general>The Japanese Society of Internal Medicine</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240215</creationdate><title>Clinicopathologic Features of Adult-onset Still's Disease Complicated by Severe Liver Injury</title><author>Kurokawa, Miho ; 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| subjects | acute liver injury Adrenal Cortex Hormones - therapeutic use Adult adult-onset Still's disease Case Report CD8 antigen CD8-positive cells Cell differentiation Corticosteroids Humans Immunosuppressive agents Immunosuppressive Agents - therapeutic use Infiltration Inflammatory diseases Juvenile rheumatoid arthritis Liver Liver diseases Still's Disease, Adult-Onset - complications Still's Disease, Adult-Onset - drug therapy |
| title | Clinicopathologic Features of Adult-onset Still's Disease Complicated by Severe Liver Injury |
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